By MICHAEL KITCH, LACONIA DAILY SUN
LACONIA — "We've been through choppy waters," said Kevin Donovan, who in June became the third president and chief executive officer of LRGHealthcare since the retirement of Tom Clairmont in 2014, "but there is smooth sailing ahead."
Donovan, whose family includes medical clinicians and hospital administrators, has worked in health care since the 1990s, most recently at Mt. Ascutney Hospital and Health Center in Windsor, Vermont. He served as a senior vice president at the Elliot Health System in Manchester, director at the Dartmouth-Hitchcock Medical Center in Lebanon, as well as an administrator of hospitals and physician practices in Massachusetts. With his wife and four children, Donovan has moved from New London to Belmont to make a long-term commitment and forge strong relationships in the Lakes Region.
"There has been so much change all at once," Donovan said, adding that change takes its toll on the members of any organization. Lakes Region General Hospital has struggled financially, with thin operating margins and even operating losses since 2010. Senior leadership has shuffled. This spring, 58 positions were eliminated. A restructuring of operations recommended by a team of consultants is underway. Last and least, the off-site laundry facility burned to the ground in 2013.
Donovan said LRGH has posted a positive operating margin for the past six months.
"It's small, but positive," he said. "We've turned the corner, but not without pain."
In particular, he said that, apart from coping with the rigors of change, employees "have had no pay raise for a very long time." Recognizing the contribution and improving the morale of employees by "reinvesting in our workforce," he called that an immediate goal. "Happy satisfied employees," he remarked, "make for happy, satisfied patients."
The shortage of nursing, clinical and technical personnel, Donovan described as "a real challenge. It's very hard to find these people," he continued. "We have to offer a fair wage for a fair day's work."
At the same time, LRGH engaged Prism Healthcare Partners, a consulting firm, to assist with strengthening its financial performance. Between $18 million and $26 million in operating efficiencies and and cost savings have been identified and measures to achieve them while improving the quality of care and experience of patients are underway.
Looking ahead, Donovan expected that the rapid aging of the population LRGH serves would significantly increase the demand for care. To meet the demand while managing the costs will require continuing to shift from inpatient care to outpatient care, which minimizes hospital stays.
"The outcome are better and the costs are lower," he said. Investing in primary care aimed at keeping people well and managing chronic illnesses, he said, is a significant component of this approach to health care.
Donovan referred to "smart growth," or tailoring the care and services LRGH offers to the needs of the community it serves. He said "I have four or five programs in mind," but mentioned only orthopedics, explaining that with its investment in MAKOplasty, a robotic surgical procedure for knee and joint replacement, LRGH is positioned to meet the projected increased demand for joint replacement.
The planned expansion and renovation of the emergency department, a $13 million project broached last year, Donovan said "is in the parking lot." Although he described the existing facility as "woefully inadequate," he said that the emergency unit at LRGH had the best metrics among the five hospitals in the Granite Health Network, a consortium of Catholic Medical Center, Concord Hospital, Southern New Hampshire Health and Wentworth-Douglass Hospital. He said the project is "on hold pending development of a sustainable financial plan." In the meantime, Donovan said, a four-bed psychiatric unit with a dedicated staff has been carved out of the emergency room to care mentally ill patients awaiting space at New Hampshire Hospital.
"Cooperation,and partnerships " Donovan said, "are the future of health care. " He pointed to LRGH's the partnership with Speare Memorial Hospital to introduce electronic medical record-keeping systems. As a member of the Granite Health Network, LRGH partners with five hospitals to share knowledge and experience to improve the quality and control the cost of care by applying best practices. The network itself partnered with Tufts Health Plan to form an insurance company, the Tufts Health Freedom Plan, the first health insurer wholly owned by health care providers. The 15,000 employees in the network have been enrolled and the Tufts Health Freedom Plan will compete will compete with other carriers in the New Hampshire marketplace.
Donovan stressed that while he has climbed "a steep learning curve" since joining LRGH, he is very familiar with the health care community in New Hampshire, where he has lived for the past 17 years.
"I worked at Dartmouth-Hitchcock Medical Center and Elliot Hospital," he said. "I know the New Hampshire Hospital Association. I have a good network and know the players."
With some 1,500 employees, more than 900 of them professional medical and clinical personnel, Donovan said LRGH is a significant element of the local economy and social fabric. "We are seeking to re-engage the community," Donovan said, "and to rebuild the faith and confidence of community."
Kevin Donovan, the new CEO and president of LRGH, who said he has aspired to lead a community hospital for as long as he can remember, believes LRGHealthcare has turned the corner. (Michael Kitch/Laconia Daily Sun)